Auni Lindgren1, Maarit Anttila2, Otso Arponen3, Suvi Rautiainen4, Mervi Könönen5, Ritva Vanninen6, Hanna Sallinen7. 1. University of Eastern Finland, Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, Obstetrics and Gynecology, Finland. Electronic address: Auni.lehikoinen@gmail.com. 2. University of Eastern Finland, Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, Obstetrics and Gynecology, Finland; Department of Gynecology, Kuopio University Hospital, Kuopio, Finland. Electronic address: maarit.anttila@kuh.fi. 3. Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland. Electronic address: otso.arponen@kuh.fi. 4. Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland. Electronic address: suvi.rautiainen@icloud.com. 5. Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland. Electronic address: mervi.kononen@kuh.fi. 6. Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; University of Eastern Finland, Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, Clinical Radiology, Finland; University of Eastern Finland, Cancer Center of Eastern Finland, University of Eastern Finland, Kuopio, Finland. Electronic address: ritva.vanninen@kuh.fi. 7. Department of Gynecology, Kuopio University Hospital, Kuopio, Finland. Electronic address: hanna.sallinen@kuh.fi.
Abstract
OBJECTIVES: To investigate whether semi-quantitative and pharmacokinetic perfusion dynamic contrast-enhanced (DCE) parameters are associated with traditional prognostic factors and can predict clinical outcome in ovarian cancer (OC). METHODS: This prospective study, approved by local ethical committee, enrolled 38 patients with primary OC, 2011-2014. After preoperative DCE-MRI (3.0 T), two observers measured perfusion (Ktrans, Kep, Ve, Vp) and semi-quantitative parameters (area under the curve, peak, time-to-peak) by drawing regions of interest (ROIs) covering the large solid lesion (L-ROI) and the most enhancing small area (S-ROI) (NordicICE platform). Kruskal-Wallis was used to analyze associations between MRI parameters and classified prognostic factors. RESULTS: Mean Ktrans values were higher in high-grade serous OC than in other types (L-ROI, P = 0.041; S-ROI, P = 0.018), and lower mean Ktrans values predicted residual tumor (L-ROI P = 0.030; S-ROI, P = 0.012). Higher minimum Vp values were associated with higher International Federation of Gynecology and Obstetrics (FIGO) stage (S-ROI, P = 0.023).Shorter recurrence-free survival was predicted by higher Ve (minimum L-ROI, P = 0.035; maximum S-ROI, P = 0.046), Vp (maximum S-ROI, P = 0.033), and lower time-to-peak (maximum S-ROI, P = 0.047) in Kaplan-Meier analysis. Multiparametric MRI variables combining DCE and diffusion weighted data were also predictive for survival. CONCLUSION: DCE-MRI parameters may represent imaging biomarkers for predicting tumor aggressiveness and prognosis in OC. Higher Ktrans levels were associated with better results in cytoreductive surgery but with earlier recurrence.
OBJECTIVES: To investigate whether semi-quantitative and pharmacokinetic perfusion dynamic contrast-enhanced (DCE) parameters are associated with traditional prognostic factors and can predict clinical outcome in ovarian cancer (OC). METHODS: This prospective study, approved by local ethical committee, enrolled 38 patients with primary OC, 2011-2014. After preoperative DCE-MRI (3.0 T), two observers measured perfusion (Ktrans, Kep, Ve, Vp) and semi-quantitative parameters (area under the curve, peak, time-to-peak) by drawing regions of interest (ROIs) covering the large solid lesion (L-ROI) and the most enhancing small area (S-ROI) (NordicICE platform). Kruskal-Wallis was used to analyze associations between MRI parameters and classified prognostic factors. RESULTS: Mean Ktrans values were higher in high-grade serous OC than in other types (L-ROI, P = 0.041; S-ROI, P = 0.018), and lower mean Ktrans values predicted residual tumor (L-ROI P = 0.030; S-ROI, P = 0.012). Higher minimum Vp values were associated with higher International Federation of Gynecology and Obstetrics (FIGO) stage (S-ROI, P = 0.023).Shorter recurrence-free survival was predicted by higher Ve (minimum L-ROI, P = 0.035; maximum S-ROI, P = 0.046), Vp (maximum S-ROI, P = 0.033), and lower time-to-peak (maximum S-ROI, P = 0.047) in Kaplan-Meier analysis. Multiparametric MRI variables combining DCE and diffusion weighted data were also predictive for survival. CONCLUSION:DCE-MRI parameters may represent imaging biomarkers for predicting tumor aggressiveness and prognosis in OC. Higher Ktrans levels were associated with better results in cytoreductive surgery but with earlier recurrence.
Authors: Carmen Herrero Vicent; Xavier Tudela; Paula Moreno Ruiz; Víctor Pedralva; Ana Jiménez Pastor; Daniel Ahicart; Silvia Rubio Novella; Isabel Meneu; Ángela Montes Albuixech; Miguel Ángel Santamaria; María Fonfria; Almudena Fuster-Matanzo; Santiago Olmos Antón; Eduardo Martínez de Dueñas Journal: Cancers (Basel) Date: 2022-07-19 Impact factor: 6.575